Childhood mental health and adult family relationships: How ADHD shapes experiences with intimate unions and parenthood

Increasingly recognized as a chronic condition that can endure across the life course, childhood attention-deficit/hyperactivity disorder (ADHD) is associated with less stable family formation and more strain around intimate unions (dating, cohabitation and marriage) and parenthood. This article reviews and evaluates multidisciplinary research on childhood ADHD, intimate unions and parenthood, with the purpose of motivating future sociological research in this area. The paper is organized into three general sections. First, I provide an overview of information on ADHD including its diagnosis and treatment, cross-disciplinary etiologies, and sociodemographic correlates. Next, I blend sociological perspectives on labeling and stigma, social stress, and the life course to consider the role of ADHD-related stigma in shaping associations of childhood ADHD with family formation processes (intimate unions and parenthood) and family functioning (relationship quality and communication) in adulthood. Finally, I discuss opportunities for future sociological research on childhood ADHD and adult family relationships that have the potential to contribute both to empirical research on childhood ADHD and adult family relationships, as well as to sociological research at the intersection of family and health.     

A Social Constructivist Perspective on the Potential Relevance of Selected DSM‐5 Disorders for South African Children and Youth

In South Africa, careless implementation of child psychiatry's biomedical model of ‘mental disorder’ could stigmatise children and youth who have been made vulnerable by the lingering effects of apartheid — poverty and malnutrition, violence and abuse, and the HIV/AIDS pandemic. A focus on DSM‐5 category changes — regarding post‐traumatic stress disorder and ADHD — demonstrates that these psychiatric labels are impracticable and irrelevant in a post‐colonial developing country, where mental health care is delivered in the context of scarce services and unequal access. A social constructivist perspective enables us to broaden policy decisions and suggest directions for research.     

Attention Deficit‐Hyperactivity Disorder as the Medicalization of Childhood: Challenges from and for Sociology

Sociology has problematized the expanding province of medicine for several decades, and it is important to clarify some of the central questions regarding the medicalization question for those new to this subset of the discipline. With a primary focus on the diagnosis of attention deficit‐hyperactivity disorder (ADHD), this paper seeks to accomplish four goals. First, this paper will summarize the general concept of medicalization, including the way that medical practitioners attribute children’s behavioral problems to disease entities. Second, this paper argues that the medicalization of childhood and the rise of the disease entity of ADHD stems from the transformation of children and childhood into objects of scientific study. Third, using the example of ADHD, this paper will attempt to demystify the premise that medicalization emanates from the “monolith” of medicine, but is instead, a process rife with internal contradiction and epistemological disagreement. Fourth, following the uncertainty of etiological positions toward childhood behavior problems, this paper will discuss some of the external critiques of medicalization, including the way that lay actors push back against the medicalization process, and concerns about the effectiveness of technologies used to diagnose and treat ADHD.     

Current trends in medicalisation: Universalising ADHD diagnosis and treatments

There is a wide sociological debate that documents how inattention, hyperactivity, and impulsive behaviours from a certain point forward cease to be disturbing behaviours and become childhood psychiatric disorders—named attention deficit/hyperactivity disorders (ADHD)—to be responded to with specific treatments since these behaviours are supposed to have a negative or pervasive impact on social and personal functioning and quality of life. Looking back over the stages of this debate, the article will focus on what, in recent years, are the two main directions of the expansion of the domain of medicalisation: on the one hand, discussing how the ADHD category has changed by moving from being typically a childhood problem to a disorder that can affect adults and, on the other, how it tends to globalise conquering new markets outside the United States, Canada, and Australia. The article concludes commenting on how the processes of lifelong expansion and worldwide diffusion is universalising the medical category, overcoming the disciplinary and geographical boundaries in which ADHD was created and developed.     

Attention Deficit Hyperactivity Disorder (ADHD) and Diverse Populations

Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly diagnosed behavioral disorder of childhood. Given the high prevalence of ADHD and its significant impact on children and families, it is important for social workers to understand and know how to respond. This paper looks at Attention Deficit Hyperactivity Disorder, explores its causes, and gives special attention to its effect on diverse populations. In addition, it discusses empirically supported treatment interventions used for children with ADHD, particularly the role of parent training in the management of ADHD. Finally, it discusses the applicability of using parent-training programs with diverse populations.     

Helping parents decide on ADHD treatment for their children

In the United States, medication is often the first intervention used to treat attention-deficit/hyperactivity disorder (ADHD). Yet psychosocial interventions with both parents and teachers working together to shape the child's behavior can also be an effective approach, enabling smaller amounts of medication to be used with fewer side effects. An overview of behavioral interventions is provided with a focus on parent training in child behavior management and teacher training in classroom management. Key nursing interventions on behalf of children with ADHD include assessing parental knowledge about treatment, listening supportively to parents, and promoting partnerships among parents, teachers, and providers.     

Autism Spectrum Disorder: The Impact of Stressful and Traumatic Life Events and Implications for Clinical Practice

Research findings suggest that behavioral interventions are effective in improving educational outcomes and fostering skill development in people with autism spectrum disorder (ASD). However, high rates of comorbidity between ASD and other psychological disorders, including depression and anxiety, indicate that standard behavioral approaches are not adequately addressing issues related to mental health in this population. Research emerging since the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is advancing our understanding of the nature of childhood stress and trauma in people with ASD and its subsequent impact on mental health and wellbeing. Mounting evidence for stress and trauma as a risk factor for comorbidity and the worsening of core ASD symptoms may intimate a shift in the way clinical social workers and other clinical practitioners conceptualize and approach work with this population to include trauma-focused assessment strategies and clinical interventions. Future directions for research to better understand the nature of childhood stress and trauma and improve mental health in this population are also discussed.     

The Political Economy of Institutional Landownership: Neorentier Society and the Financialization of Land

In recent decades a substantial shift in landownership has taken place in rural America as millions of acres of land have come under the ownership and control of various financial institutions. This article outlines a political economic framework for explaining and interpreting the significance of this proliferation of institutional investments into rural lands. Focusing on two of the nation's most important rural land resources—timberland and farmland—I suggest that we are witnessing an unprecedented integration between finance capital and landownership that harkens back to previous eras of rentier control. I further suggest that this increasing tendency to treat land as a financial asset—what I refer to as the “financialization of landownership”—gives rise to a number of contradictions that may have profound effects on rural communities across the United States. I conclude with a discussion of a land bubble and the role of institutional landowners in pushing up land prices in both timberland and farmland markets.     

Psychosocial interventions used to treat children with ADHD: safety and efficacy

Although stimulant therapy is the most common treatment for attention-deficit/hyperactivity disorder (ADHD) in children, it is not always effective in reducing behavioral symptoms. As a result, research on psychosocial interventions has progressed in recent years. This article provides a synopsis of psychosocial interventions for childhood ADHD, with an emphasis on basic behavior management principles, evidence-based interventions, and safety issues. Developmental issues that distinguish psychosocial interventions for children and adolescents are highlighted, and practical recommendations for collaborating with mental health professionals are provided.     

THE EFFECTIVENESS OF FAMILY THERAPIES FOR SELECTED BEHAVIORAL DISORDERS OF CHILDHOOD

This article reviews the scientific evidence for the effectiveness of family-based aproaches in the treatment of selected childhood behavioral disorders. Although limitations certainly exist, family interventions have consitently improved child and, in some cases, parent functioning in families with children presenting with conduct disorder (CD) and autism. Parents and other family members also directly benefit from child-focused interventions, gaining in knowledge, child management skills, and attitudinal improvements. Longh-term follow-ups indicate that CD and autistic children achieved lasting gains. Similarly, the research on attention-deficit/hyperactivity disorder (ADHD) indicates that parent training improves child noncompliance and aggression yet does not consistently affect core symptoms of ADHD. There is no evidence that adding short-term family interventions improves ADHD child functioning beyond improvements from the use of psychostimulant medications. Some tentative support for family involvement in the treatment of childhood anxieties and fears is reviewed, but clear conclusions await future investigations. Finally, several methodological limitations and needed areas of research are discussed.     

Medication for Children with Attention-Deficit Hyperactivity Disorder

When making assessments and planning interventions, social workers adopt a biopsychosocial perspective. One important area where biologically based treatments influence psychosocial functioning is the area of psychopharmacology. However, even though many clients take medications, social workers often feel poorly prepared to address a subject that could be very important to their clients; that subject is the meaning of the medication to the client. The meanings that clients ascribe to medication can have a significant impact on medication adherence. Using attention-deficit/hyperactivity disorder (ADHD) to illustrate, I provide an overview of ADHD and common forms of treatment, discuss the possible meanings and acceptability of stimulant treatment for ADHD, provide practice guidelines for helping families reduce ambivalence about medication, present two clinical vignettes, and suggest resources for social workers and families.     

Managing Categorization and Social Withdrawal in Japan: Rehabilitation Process in a Private Support Group for Hikikomorians

Abstract: Social withdrawal among Japanese youth has been noticed since the latter‐half of the 1990s. It is called Hikikomori in Japan. Though some clinicians in the mental health field have referred to social backgrounds of this problem, only a few sociological studies have been conducted. I have conducted participant observation in a private support group and recorded the rehabilitation processes of people with Hikikomori for two years. My study has two aspects. First, it is a short ethnography concerning the features of the group efforts. Second, it is intended to interpret relations between the features and rehabilitation processes. The first feature is the group dynamics arising from friendly and competitive relationships among the people with Hikikomori—called Hikikomorians. The second feature is “managing categorization”. It is a tendency to be vague about categories that indicate their social status accompanied with some roles. This tendency could be observed in various aspects of the group activities, for example, concerning diseases’ names, schedules, definition of space and so on. Managing categorization allows Hikikomorians to easily participate in and experience social activities. They are people who do not have social categories to explain themselves easily in social settings and do not have the self‐confidence to perform some roles. Under social pressures, however, they tend to maintain a behavioral principle that is based on categories. Managing categorization therefore functions to provisionally release their attitudes and allow them to attempt trial and error based situations more easily. Finally, I also indicate some difficulties of managing categorization.     

The Development of Referential Communication and Autism Symptomatology in High‐Risk Infants

Non‐verbal referential communication is impaired in children with autism spectrum disorders (ASD). However, the development of difficulties with referential communication in the younger siblings of children with ASD (High‐Risk Siblings)—and the degree to which early referential communication predicts later autism symptomatology—is not clear. We modeled the early developmental trajectories of three types of referential communication: responding to joint attention (RJA), initiating joint attention (IJA), and initiating behavioral requests (IBR) across 8, 10, 12, 15, and 18 months of age in High‐Risk Siblings (n = 40) and the infant siblings of children without ASD (Low‐Risk Siblings; n = 21). Hierarchical linear modeling indicated that High‐Risk Siblings exhibited lower levels of baseline RJA and IJA and a lower rate of linear change in IBR than Low‐Risk Siblings. When the 10 High‐Risk Siblings who received an ASD diagnosis were excluded from analyses, group differences in the development of referential communication remained significant only for RJA. Baseline levels of IJA were associated with later ASD symptomatology among High‐Risk Siblings, suggesting that individual differences in referential communication development at 8 months may index early manifestations of ASD.     

The leap from ROI to SROI: Farther than expected?

Social return on investment (SROI) is a popular method for evaluating the impact that organizations have on society and the environment. It has its roots in finance, where return on investment (ROI) is used to evaluate investments. Over the past ten years, SROI has made the leap from a tool for building private wealth to one that advances the public good. Has it landed us in a better place? To answer the question, I describe the general approach to financial analysis, how it is applied to financial decisions, and how it has been adapted to evaluate impact. I then consider the strengths and weaknesses of SROI, and suggest how, by pushing beyond the constraints of financial analysis, it can give stakeholders voice and provide evidence of success from diverse perspectives. Along the way, I propose a conceptual model for value, a foundational concept in SROI that has been criticized by some as underdeveloped, and I include a technical appendix that identifies potential sources of statistical bias in SROI estimates. I conclude by acknowledging our growing need to incorporate efficiency as one of multiple success criteria and the role that SROI—properly implemented—can play.     

Rethinking Post-Fordism: The Meaning of Workplace Flexibility

Social scientists increasingly claim that work structures based on the mass production or "Fordist" paradigm have grown obsolete, giving way to a more flexible, "post-Fordist" structure of work. These claims have been much disputed, however, giving rise to a sharply polarized debate over the outcome of workplace restructuring. I seek to reorient the debate by subjecting the post-Fordist approach to theoretical and empirical critique. Several theoretical weaknesses internal to the post-Fordist approach are identified, including its uncertain handling of "power" and "efficiency" as factors that shape work organizations; its failure to acknowledge multiple responses to the crisis of Fordism, several of which seem at odds with the post-Fordist paradigm; and its tendency to neglect the resurgence of economic dualism and disparity within organizations and industries. Review of the empirical literature suggests that, despite scattered support for the post-Fordist approach, important anomalies exist (such as the growing authority of "mental" over manual labor) that post-Fordism seems powerless to explain. In spite of its ample contributions, post-Fordist theory provides a seriously distorted guide to the nature of workplace change in the United States. Two alternative perspectives toward the restructuring of work organizations are sketched—neoinstitutionalist and "flexible accumulation" models—which seem likely to inspire more fruitful lines of research on the disparate patterns currently unfolding within American work organizations.     

Parents of Children with Attention Deficit/Hyperactivity Disorder: A Meta-Synthesis,Part I

In 2011 6.4 million children in the United States ages four to 17 years had a diagnosis of Attention-deficit/hyperactivity disorder (ADHD). Quantitative studies have indicated that parenting stress for parents of children diagnosed with ADHD is high. This meta-synthesis compiled and analyzed a systematic review of the qualitative studies of parents’ lived experience of having a child with ADHD. Searches in online scholarly databases yielded an initial 1217 hits, which were narrowed down to seventy-three studies that met the criteria. A “meta-ethnography” framework was used for the synthesis. One major finding involved the emotional burden of caring for a child with ADHD. Parents struggled with a variety of intense and painful emotions as they attempted to manage family routines. Disciplining children only worked in a limited way and took constant effort throughout the day. The challenges of parenting spilled into other areas of the parents’ lives, such as their health, psychological, marital, and occupational functioning. Implications for practitioners are discussed, including the need to validate parental stress and the difficulty of applying behavioral management strategies with their children, the need for increased support of partner relationships, and the need to connect parents with support to prevent poorer outcomes for the child.     

Effects of autism spectrum disorder on parental employment in the United States: evidence from the National Health Interview Survey

Using results of the US National Health Interview Survey (US-NHIS) for the years 1998–2013 we investigated the impact of having a child with autism spectrum disorder (ASD) on parents’ work behavior. After controlling for numerous background characteristics, we found that having a child with ASD lowered the number of hours of market work per week and the number of months of market work in the previous year for mothers. For fathers, having a child with ASD also reduced the number of hours of market work per week and the number of months of market work in the previous year. However, the magnitude of the effects were smaller for fathers than for mothers, and more sensitive depending on whether the estimates were derived from a linear regression model or propensity score models. Some evidence was also found that the impact of having a child with ASD on parents’ market work depended on whether or not the child with ASD also had an intellectual disability, the parent’s education level, immigration status, and parent race/ethnicity.     

Appreciating the world of autism through the lens of video interaction guidance: an exploration of a parent’s perceptions,experiences and emerging narratives on autism

This study seeks to identify understandings and narratives around autism spectrum disorder (ASD) through the application of video interaction guidance (VIG). In adopting a social constructionist approach, the case study used a person-centred model to explore a parent’s experiences and emerging narratives of ASD through the lens of VIG. Findings of the current study suggest that VIG offers an effective tool for in-depth exploration of complex, multi-storied understandings of ASD and the perceived parental role. The intervention was perceived to promote greater awareness of the child’s communication skills, beyond the ‘common’ understandings of ASD, by providing a novel outsider perspective on interactions. The intervention also promoted parental efficacy through recognition of parenting skills in supporting the development of strength-based narratives. VIG was seen to provide a platform for an exploration of existing narratives and the construction of new, preferred realities.     

Modernisierung und Demokratisierung

Most social scientists agree that democracy is essentially a product of modernity: As soon as a society follows the path of modernization, especially by implementing economic reforms, a democratic transition seems inevitable. As the complexity of society increases, the demands on the governmental performance of the state rise. Accordingly, authoritarian developmental regimes will be replaced in the long term by liberal democracies. But the causes and mechanisms between modernization and democratization are still unclear. While most studies are based on functionalist concepts, this article explores the subject from a constitution theoretical perspective. The argument is developed in four steps: In the first step, I will discuss the contributions of Parsons and Luhmann to the explanation of democratization processes. In the second step, I will give an overview of recent non-functionalist concepts for the analysis of differentiation processes. In the third step, these concepts are used in order to investigate the relation between modernization and democratization on the case of South Korea (1979–1987). This empirical study focuses on structures of inequality in the social subsystems, the carriers and motives of pro-democratic protests, and finally the temporal patterns of interaction between the South Korean democratization movement and the authoritarian regime. In the fourth step, the explanatory potential of non-functional differentiation theories for the analysis of democratization processes will be discussed.     

Behavioral economics has two ‘souls’: Do they both depart from economic rationality?

In this paper, I argue that behavioral economics, far from being a monolithic theory, consists of two different ‘souls’ and that a fundamental asymmetry exists between them, with regard to the nature of the departures from the economics’ ‘canonical model’ they focus on. While a first class of departures deals with the major cognitive limitations and systematic biases in decision-making affecting economic behavior, a second research area investigates deviations from the classic assumption that economic agents are systematically driven by the pursuit of material self-interest. Even though on methodological grounds the two research areas share a broadly inductive approach – as they both aim at incorporating the major results obtained through several empirical methods (in particular, via experimental work) into formal economic analysis –, I claim that rather different methodological conclusions and regulatory and policy implications can be drawn, depending on the cognitive or social nature of the departures from the standard economic model under study.